School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
Disabil Rehabil. 2020 Oct;42(20):2882-2893. doi: 10.1080/09638288.2019.1574913. Epub 2019 Apr 11.
This study aimed to understand parent engagement and disengagement in the delivery of occupational therapy to their children. This study used a qualitative interpretive description methodology. Focus groups and individual interviews were employed. Thirty-two occupational therapists participated in focusgroups or one-on-one interviews. Thematic analysis was used to analyse the data. Thematic analysis of the data revealed two overarching themes which influenced parent engagement and disengagement in therapy: (1) Parent-therapist relationship and; (2) Therapist responsiveness. Within these two themes: parent feelings; time and timing of therapy; levels of engagement and factors influencing parent engagement were evident. Findings contribute to understanding parent engagement and disengagement in therapy. The findings extend current models of therapeutic engagement in occupational therapy informed by self-determination theory (SDT). Autonomy-, relatedness- and competence-supportive SDT strategies to enhance parent engagement in therapy are described.Implications for RehabilitationOccupational therapists reported that parents experience a range of feelings when engaged and disengaged in therapy. These feelings related to hopelessness, having confidence in the therapist and feeling supported, validated and empowered. Parent engagement and disengagement in therapy was described by occupational therapists as occurring at different levels: when it works well (engaged); engaged in the idea of therapy but not engaged in the doing of therapy (middle ground engagement); and when it doesn't work well (disengagement).Occupational therapists reported the importance of being aware of how the factor of time and family, service and therapist characteristics can variously impact parent engagement in therapy.Occupational therapists focus on the parent-therapist relationship and being responsive to parent needs and feelings when engaging parents in therapy.Occupational therapists can draw on principles from self-determination theory to guide them regarding the selection of strategies to engage parents in therapy.
本研究旨在了解家长在为其子女提供职业治疗服务过程中的参与和不参与情况。本研究采用定性解释性描述方法。使用焦点小组和个人访谈。32 名职业治疗师参加了焦点小组或一对一访谈。采用主题分析法对数据进行分析。对数据的主题分析揭示了两个影响家长参与和不参与治疗的总体主题：（1）家长-治疗师关系；（2）治疗师的反应能力。在这两个主题中：家长的感受；治疗的时间和时间安排；参与程度以及影响家长参与的因素显而易见。研究结果有助于了解治疗中的家长参与和不参与情况。研究结果扩展了目前基于自我决定理论（SDT）的职业治疗中治疗性参与的模型。描述了增强治疗中家长参与的自主、相关和能力支持性 SDT 策略。
康复的意义
职业治疗师报告说，当父母参与和不参与治疗时，他们会有一系列的感受。这些感受与绝望、对治疗师的信心、感到支持、认可和赋权有关。职业治疗师将治疗中的家长参与和不参与描述为发生在不同的水平：当治疗效果良好时（参与）；对治疗的想法感兴趣但不参与治疗的执行（中间地带参与）；以及治疗效果不佳时（不参与）。职业治疗师报告说，了解时间和家庭、服务和治疗师特征等因素如何对治疗中的家长参与产生不同影响非常重要。
职业治疗师注重家长-治疗师关系，并在让家长参与治疗时对家长的需求和感受做出反应。
职业治疗师可以借鉴自我决定理论的原则，指导他们选择策略来让家长参与治疗。
